In Ohio, My Kitty Boo

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Wow..so now it is 427...so now I am doubting the afternoon reading..yes he ate a little more of his canned food, but shouldn't have jumped like that? So what do I do??
 
You are fine to shoot.

I suspect he is bouncing. Bouncing happens when the cat blood glucose drops low, or lower than its body is used to.. Since it's become used to being high! The liver panics at the "low" and causes the blood sugar to rise artificially. The blood sugar will sit high for up to 72 hours, no matter that you are shooting insulin, and then come back down again.

The important thing is we need to know how low he went. If it was under 50 it might explain him not feeling well. And if it was under 50 it means his insulin dose was too high.

So now we need to catch the next low. So hold the same dose (I would choose 1.5 units) for 3 days and test to see how low it takes him once the bounce clears. I would test before every shot, plus a test during the day and one before bed. Once you see his numbers drop, which could take a couple of days, start to test every 2-3 hours , or more often if it looks like he will go under 50. And keep us updated.

Wendy
 
Because he wasn't eating, he might have gone lower than normal, or lower fast, either can trigger a bounce.

Really keep an eye on his eating, as vomiting, diarrhea,or lack of appetite can really drop numbers if you don't spot it. My first diabetic, Spitzer, developed IBD, and it was nearly impossible to use Lantus at a stable higher dose because he'd have an episode of vomiting and it would be too much. I had to get creative and use supplemental short acting insulin to handle when he was higher.
 
Thank you. I will do give him 1.5 units. I don't know how low he went or even if he went low? So in the morning I will check it again, before he eats and if it is the same..like 400's I should give him 1.5 again...and keep going with that for 3 days...keeping track of mornings, before he eats..afternoon..and before he eats at night. I will post every time I check it and will monitor his food..giving him only the Royal Canin wet canned food.

Am I understanding right? I am going to give him his 1.5..should I wait a couple hours and retest before I go to bed?

BJM. You mentioned about the short acting...you see...I am a diabetic, and sometimes I get a bounce if I may have gone low at night, but my sugars will be high the next morning, but I still have to get it back down in the normal range, so I use the short acting and do my carb count to eat and then the extra and give my short acting..humalog or novalog.

Boo is having some bad gas..(which he never has had before) not sure if it is this new food. Never had diarrhea, but his stool has been less consistency and stinks to high heaven.
 
If his pancreas is inflamed, it may be disrupting normal digestive enzyme production. That, or a bacterial overgrowth in the GI tract (among other things) can cause very foul smelling feces. This is something to discuss with the vet. It could be worth an empirical trial of pancreatic enzyme supplements and something to treat a bacterial diarrhea.

The bolus principle is the same, however we don't suggest that for new folks managing feline diabetes. We like to get them steady on the primary, long acting insulin first, then determine if there may be special circumstances to be managed, such as acromegaly, Cushings, or insulin autoantibodies (IAA).
 
The vet said he didn't have pancreatitis. I read the article on this, and looking at all of his blood work which is normal..only thing that was maybe a watch is his BUN was a high normal.

The only other way to tell would be to have that one test done, and right now I don't have the funds to do that. In February I paid over $300 out and couldn't afford my meds..now in May I have paid out over $200. I am on SSDI and I only get so much a month, so I have no way of getting extra money. I have given up taking some of my meds in order to get him help. I am through the donut hole now, so my meds are less expensive, but I still don't have extra.

This morning his BS was 321. I gave him his 1.5 units of Lantus.

Emma
 
Ok, today I am told that the Royal Canin is not an appropriate food for Boo. However i am concerned as I was feeding him the Friskies pate and he stopped eating it. I have a spread sheet that was given to me...but..money is a problem, and if raw food is better for him, what all raw food can he have. I mean I can give him like fish that i make for me like Salmon? Cod? or do I do the chicken, tuna, turkey? can it be cooked or just raw?

Food is confusing for me now.

Emma
 
I have been reading catinfo.org about cat food. I found that the Friskies Pate had 9 grams of carbs and this was what I was feeding boo when he had his incident. I don't know if the vomiting and not eating made him go low, or I don't know..I am so confused right now as to which way to go. I bought the Royal Canin because that is what the vet recommends..but now I find out it is not good for Boo.

He is sleeping at my feet today. He has jumped up on my lap a couple of times but now is just resting on my shoe. :?

So I guess I should go back to the Friskies? I still have a lot of it...or am I changing too many things?

Emma
 
Emma,

Its not good to feed a cat very much fish flavors, its just not good for them. Maybe once in awhile but not all the time. There is nothing wrong with feeding Boo the pate foods if he will eat them. That's what most people here feed their diabetic cats.

Terri
 
Emma

Did you go buy new strips? Those strips might not be good. Remember we also talked about the ketostix. Did you get those yet? Is Boo eating?

Terri
 
Yes I went and got some new strips. I know with me strips need to be used within 3 months of opening? Not sure with the cat...seems everything is different. Yes I got the keto, but I need to figure out a way to test him because I don't always catch him peeing. I don't have any funds left (actually I think I am in the hole..watching the bank account everyday) hopefully I don't bounce or go negative...but I have been emailing with Venita, but i found out I bought the cheapest, but not the right ones for them, so she will send me ones that fit your meter you gave me.

Emma
 
No I haven't as I do not know of any of the others. If you would please share where I can find a list of them?



Also Kitty Boo's BS last night at night feeding was 257

This morning it was 259

I am still on 1.5 units

Also Venita told me there is a spreadsheet that I could use for Kitty Boo's BS..could someone tell me where that is located?

Emma Birch
 
Text with a blue color and underlined is called a hyperlink.
Look at my previous post.
It has a hyperlink in it.
If you click on the hyperlink in my previous post, it takes you to some info on financial aid.
 
Hi Emma,

I don't think I have welcomed you yet, so welcome! I'm so sorry you have to be here, but I'm really glad you found this site. There are a lot of wonderful people here who can help you and Boo. Getting everything set up and "figured out" (food, shot times, spreadsheets, etc.) can be overwhelming, I know.

I saw that you had asked about the spreadsheet. Click on this link here: http://www.felinediabetes.com/FDMB/viewtopic.php?p=179835#p179835. It gives you instructions on how to set one up and gives you a link to the template we use. If you have any problems setting one up, just let us know. There are some great tech people here who can get one going for you in no time.
 
Thank you all for the information.

Last night I could not get a blood glucose for Kitty Boo, Is there maybe because I have stuck him too many times and his ears are hurting? He kept jerking away from me last night and I tried and tried, but to no avail.

This morning his sugar was 294. It seems it is running consistently in the 200's..and his appetite is back and he is eating well. Now for a 12 pound cat, how much of the Friskies should he be eating? And is it safe now to return to his 2 units of insulin yet? At 2 units he was doing well..eating and gaining weight, until the episode happened on Sunday, and i am not sure what happened whether he happened to get into the other cat's food? Someone fed him something, or someone dropped crumbs of something? I don't know.

Also I called Royal Canin yesterday and found out the dry food has 28 grams of carbs for a 1 cup serving. I never gave him this much, I would put 1/2 cup in his bowl and he would only "snack" on it along with his wet food..it helped me to transition him over to wet food. He was raised on Hill's Science Diet dry since he was a kitten, and until Feb with his diabetic diagnosis, he was always a healthy, happy Kitty. So understandably I had to transition him over to wet food. Also I found out that their "wet food" (Royal Canin) has only 2 grams of carbs per can and a cat his size should be eating a little over 3 cans a day. I told them Kitty Boo does not like their food, so they said I could return it. I have him on the Friskies Pate..sticking with the chicken, turkey etc instead of the fish flavors. He seems to like those better.

Thanks for the help..but if I could get these questions answered, I would appreciate it.

Emma
 
Thank you all for the information.

Last night I could not get a blood glucose for Kitty Boo, Is there maybe because I have stuck him too many times and his ears are hurting? He kept jerking away from me last night and I tried and tried, but to no avail.

This morning his sugar was 294. It seems it is running consistently in the 200's..and his appetite is back and he is eating well. Now for a 12 pound cat, how much of the Friskies should he be eating? And is it safe now to return to his 2 units of insulin yet? At 2 units he was doing well..eating and gaining weight, until the episode happened on Sunday, and i am not sure what happened whether he happened to get into the other cat's food? Someone fed him something, or someone dropped crumbs of something? I don't know.

Also I called Royal Canin yesterday and found out the dry food has 28 grams of carbs for a 1 cup serving. I never gave him this much, I would put 1/2 cup in his bowl and he would only "snack" on it along with his wet food..it helped me to transition him over to wet food. He was raised on Hill's Science Diet dry since he was a kitten, and until Feb with his diabetic diagnosis, he was always a healthy, happy Kitty. So understandably I had to transition him over to wet food. Also I found out that their "wet food" (Royal Canin) has only 2 grams of carbs per can and a cat his size should be eating a little over 3 cans a day. I told them Kitty Boo does not like their food, so they said I could return it. I have him on the Friskies Pate..sticking with the chicken, turkey etc instead of the fish flavors. He seems to like those better.

Thanks for the help..but if I could get these questions answered, I would appreciate it.

Emma
 
The 3 large cats in the back third of my basement (with windows), including my diabetic Gracie, share a 13 oz can of Friskies pate am and pm. I divvy it up with a bit more going to Mason, as he is a larger cat than the other 2.

p.s. they are in that area because the younger cats bother them and they cannot or will not defend themselves. That results in urine everywhere but the litter boxes, loud scuffles, and occasional punctures.
 
This morning his sugar was 199. first time under 200.. I will ask again...do I continue on the 1.5 units? What goal for his sugar?

Emma
 
We really need a listing of the numbers you've been getting, as it is the whole day profiles which guide dosing.

AM pre-shot test (AMPS )=
Units given =

+2, that means any test given 2 hours after a shot, if you do a test

+5 means any test given 5 hours after a shot , if you do a test
+7 means any test given 7 hours after a shot , if you do a test
etc.
PM pre-shot (PMPS)

Lantus drops the glucose lowest somewhere between +5 and +7

Stick with your 1.5 unit dose unless he goes below 50 mg/dL.

If he goes below 50, you start giving high carb gravy or syrup in small amounts, waiting 20 minutes, re-resting, and then repeating if still low.
 
I am confused because I was told to do morning, evening (before feeding) and one mid afternoon. Keep him at 1.5 for 3 days...

Now you want me to test how often and feed? I have been posting his blood sugars and did them all except one night when he refused to let me..I posted I thought his ear was sore, is that possible? Only because it takes me 4 or 5 tries to get his BS and I have tried both ears. Maybe I am not doing it right? I am so scared I am not doing right by him.... :cry:
 
Hi Emma,

I don't think BJ (BJM) meant that you were supposed to test at those times. She was just giving you an example of how we provide test results. For instance, if you tested 2 hours after you gave Boo the morning shot, we would report that as: AM+2 = 127. That's just an example.

Can we help you get a spreadsheet set up? If we can, let us know. That's one of the easiest ways you can report your numbers.

It's possible that the kitty's ears can get sore. One thing you can do is put Neosporin on his ear after you test. (We use the gel rather than the cream.)

Are there other questions you have that we can answer? Don't be afraid to ask!
Shelly
 
Thank you Shelly. So let me get this straight, like I usually test him in the morning before his morning feed..so I enter that...but maybe if he wouldn't let me test, or I forget or something, when I do test like if it was 2 hours later I use +2 right? and if I do a mid day...I count the number of hours that have passed since his previous shot?

Yes I do need help setting up a spreadsheet. Thanks

Emma
 
Exactly.

I edited my previous post to reflect it is IF you do a test # hours after insulin, you designate it +#.

A traditional curve is to take serial measurements every two hours beginning with the pre-shot test and going until the next pre-shot. This is what a vet typically does if you bring your cat in for a curve.

A mini curve is to take serial measurements every 3 hours from pre-shot to pre-shot.
 
That's right, Emma. It's really important to get blood sugar readings before you give insulin. That reading you get in the morning is called the "AMPS" and the one you get in the evening is called the "PMPS." Then you just count from those. So.....if you gave your morning insulin at AMPS and then checked the sugar again 5 hours later, that reading would be called the "AM+5" because it was taken 5 hours after you gave the morning shot.

Let me try to pull together some really easy instructions for you on setting up your spreadsheet. I'm not the most technically savvy person - otherwise I would just set one up for you!
 
We use Google Drive and a spreadsheet/grid so you can track the glucose numbers, then share them for review and feedback.
Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Hi Emma,

I sent you a PM (private message) with instructions for setting up a spreadsheet. Look at the top left-hand side of this page. Next to "User Control Panel" you should see "1 new message." Click on the "1" and it will open up my message. (Sorry - I don't know if you've used the private message system here yet. That's why I'm giving you directions on it.)

Shelly
 
Tonight he was 321. So I did 1.5 units and fed him. I also got the spreed sheet completed for today. Let me know if it is done right?

Thanks

Emma
 
You did your spreadsheet perfectly, Emma. Yay! Have you been collecting data before today? If so, I would encourage you to put in whatever numbers you have for the other days, too. That will help those who give you dosing advice see the "big picture" a little more clearly. (You can click on my spreadsheet link down at the bottom of this post to see an example of how I listed the numbers for each day. Click on the one that says "Jersey's SS.")

Can I verify which insulin you use for Boo? Is it Lantus? We have a couple of different sections set up on FDMB for people who are using Lantus. One of them is called the "Relaxed Lantus" group. The other is called the "Tight Regulation" group. I would encourage you to start posting on one of those boards. If you'll post Boo's numbers there each day, there will be users of Lantus who will be able to help you with the dosing. To locate the groups I'm talking about, click on the "Board Index" button at the top left of this page. Then click on "Insulin Support Groups." This will bring up a list of the different support groups we have for the various types of insulin.

Do you have any questions about any of this?
Shelly
 
No questions right now, thanks Shelly! I am going to bed now, so I may get a chance to update those tomorrow. However it is Mother's Day so I am not sure what is on the schedule. (never know till the last minute on anything with my family!) But I have numbers for him all week. I stayed up tonight to watch the NASCAR race. Yeah Jeff Gordon won! So it was worth it. Happy Mother's Day. Hope you have a good day. I will get to those boards either tomorrow or next week.

Emma & Kitty boo
 
Hope you have a great Mother's Day, Emma. You'll just need to decide if you want to go with the "tight regulation" group or the "relaxed lantus" group. Then just post on the appropriate board!
 
Hi Emma, I'm new here too, but saw your post this morning. You're doing a great job! To update your spreadsheet, just log into Google Drive and click on your document. It automatically saves itself and then we can all see it here on the forum, it's pretty slick how this is all set up. It just took me way to long to figure it out, but as you can see, there are so many wonderful people that are going to help you in any way, any time.
 
Ok I have finally update his blood sugars so if you would look at them and let me know if I should increase insulin or not, or maybe I need to do that over on the Lantus boards...but someone told me about putting Neosporin gel on kitty boo's ears, and I can't find get. There is creme and ointment or creme and ointment with pain relievers. Which one do I get?

Thanks

Emma
 
Hi Emma,

Good job getting the numbers on the spreadsheet. Although these numbers can help a little, dosing is based on the where the blood sugar is at in the middle of the cycle. For Lantus, most kitties reach what is called "nadir" 5 to 7 hours after the shot. That is when blood sugar is at it's lowest. Without getting in those mid-cycle tests, we have no idea if the current dose is taking Boo too low, keeping Boo too high, or just the right amount. Can you get some of those tests in? That will really help people who are trying to help you with the dose.

I would encourage you to post on one of the Lantus boards. That's where you'll be able to get the most help with Lantus dosing. Just pick one of them to post to - either the "Relaxed Lantus" group or the "Tight Regulation" group.

It was probably me who told you about the Neosporin "gel." I'm sorry about that - I should have said the Neosporin ointment. The ointment looks like a clear gel when it comes out of the tube, so that's how we always referred to it in my house. I keep using our slang word for it now on this site. ohmygod_smile Again - my apologies!

EDIT: I'm so glad to see you found your way to the Relaxed Lantus group! You should be able to get a lot of help there.

Shelly
 
Yes, thank you. I got some time today to go there. I don't know if you all know, but I need to say a little about my health as the reason this is hard for me. I have Hep C. I got it during my child birth years by receiving blood and blood products (I am an O neg mother). I have had 2 liver transplants (they were 9 months apart) so i went thru liver failure twice. Now I have the opportunity to try the new medication that is working great on eradicating the virus. I started it on May 2nd. The side effects so far that I see is extreme fatigue. So tired that I feel like my arms and legs weigh a ton and every muscle in my body feels like it has the flu. It is really hard just to make it thru the day.

I will try to get a few mid day sugars, however he is fighting me on this and the only way I have been able to get the others is that he don't get his yum yum until I get his BS. After 4 times of sticking now, I stop whether I have it or not.

Emma
 
We often go with a '3 tries & stop' on the ear pricks, so no worries. You'll get it. Giving a low carb treat when you test may help reduce some of the resistance.

In my signature, there is a link to Secondary Monitoring Tools which also help you assess how your cat is doing. They are supplemental, that is, you don't have to do them. However, when you can't test, they may provide critical info - ex ketone testing.
 
How do his teeth look? Do you see tartar on the teeth? Red gingivitis along the gums? Any abscesses? Oral infection may reek.

How much urine output is there? Does the breath smell like urine (a sign of possible kidney failure)?

Does the breath smell fruity or like nail polish remover? Two of 3 types of ketones have distinctive odor like that.
 
I actually smells like he has been eating poopy! It is like he is passing gas out of his mouth! Yuck!
 
emmabirch said:
I actually smells like he has been eating poopy! It is like he is passing gas out of his mouth! Yuck!
What does the vet say about that?
 
Unless he recently cleaned there, I don't think that is what I've normally smelled from my cats mouths.
 
When was the last time he had his teeth checked? Any infection can spike blood sugar too, so if there is a bad tooth or something it could be causing all these issues.

Second, how are his poops now? Big puffy smelly soft pale? How many per day?

Lastly I would try and get a couple more tests during the day, especially if you shoot under 200. The key to dosing and not causing a hypo, is to find out how low the dose is taking him.. Preshot tests don't tell you this..

I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
But he eats at least 4 times a day..his sugar never goes below the 190's. Even over night. mid day ones are running around 260 to 280. Mornings are the lowest and that is 6 hours without eating. Tom feeds him before he goes to be around 2 and I am up at 8 to test him and feed him. I need to get his sugar lower as he is wanting to eat all the time!

Emma
 
Would you please add your insulin to your signature via the Control Panel in the upper left corner of the page? I believe it is the 2nd tab where you can edit that.

For ProZinc, PZI, Lantus, and Levemir, if you've not gotten any mid-cycle shots below 150 mg/dL for 5 full days on the initial dose, or 3 full days on any subsequent dose, you may increase 0.25 units. You have to have gotten mid-cycle tests in the +5 to +7 hours after the shot to know how low he is going. (My phone doesn't always let me see the spreadsheets)
 
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